Exclusive: Campaign aims to save nurse jobs with 'good housekeeping'

Nurses will be encouraged to look for ways to save money on essentials, such as gloves and syringes, as part of a major campaign being developed by the Royal College of Nursing and NHS Supply Chain.

The campaign, which is still in its planning stages, will highlight how nurses on the ground can contribute to making cost savings – and ultimately help protect nursing jobs.

“This is about all of us taking a little bit of responsibility. If we don’t make changes then our NHS is not going to be sustainable”

Mandie Sunderland

Organisers estimate nurses working together with procurement managers could save more than £30m – the equivalent of 1,000 nursing jobs – just by streamlining the purchasing of basics like wipes, incontinence products and cannulae.

The campaign is the brainchild of Mandie Sunderland, chief nurse at Pennine Acute Hospitals Trust and the RCN’s representative on the NHS Supply Chain’s customer board. She told Nursing Times she was keen to identify ways nurses could contribute to boosting efficiency and making savings “to protect the frontline”.

Mandie Sunderland

She said she was inspired by the success of a project to standardise products while she was chief nurse at Heart of England Foundation Trust, which saved £700,000 in one year.

“That’s quite a lot of nursing jobs. If you can do that in one trust imagine how much we can save if we do it across the NHS,” she told Nursing Times. “I don’t want to be looking to save money from my nursing budget, so I would rather nurses looked to see if we can do things differently through what is essentially good housekeeping.”

The campaign, which is due to launch officially in January next year, will feature a range of resources for nurses plus support and advice from the national procurement body NHS Supply Chain.

It could also include a spot of healthy competition with nursing teams challenged to see who can save the most money.

Some of the resources are due to be tested at Pennine Acute and include a card that sets out the potential savings from getter better deals on clinical products – spelt out in numbers of nursing jobs.

For example, the partners estimate it would be possible to save £6.9m on exam gloves – which could equal 230 nurses – and £5.48m on disposable wipes, cleaning cloths and associated products – about 182 nurses.

“If we can help trusts and nurses make savings, then there is more money to ideally to protect the frontline”

Rosalyn Sands

The trust has also just started using nurse-shaped red, amber and green stickers in storerooms to flag up the most expensive items, those that are mid-price and the cheaper products.

“We’re looking at what we can do to make nurses aware of the cost of what we use,” said Ms Sunderland. “We tend to just open a drawer and get out what we need and go away.

“This is about all of us taking a little bit of responsibility,” she said. “If we don’t make changes then our NHS is not going to be sustainable.”

Rosalyn Sands, stakeholder manager for NHS Supply Chain, which manages the sourcing, delivery and supply of healthcare products and food to the NHS, noted that she normally worked with heads of procurement.

However, she said clinicians like nurses made decisions every day about the products they used and were often responsible for online ordering, so had a vital role in helping the NHS save money.

“If we can help trusts and nurses make savings, then the idea is there is more money to go round elsewhere and ideally to protect the frontline,” she said. “One of the key ways to save money is to standardise, so instead of buying five different kinds of gloves, just buy one or two.

“People can also look at the way they order things – are they ordering five times a month rather than once a month and ordering in bulk?”

“We don’t think it is right to complain about something without trying to find solutions”

Janet Davies

The campaign has the working title of Nurses Take Control and another key element will be encouraging nurses to work more closely with procurement professionals.

“One of the first things we’ll be saying is to make friends with the people who are procuring in your organisation – make sure you know what they are doing and they know what you’re doing,” said Janet Davies, director of nursing and service delivery at the RCN.

Janet Davies

“What we know is that where these conversations happen, that’s where we’re seeing the good results.”

As well as saving money, those behind the campaign say standardising products across trusts could help improve patient safety by reducing the risk of nurses struggling to use items they are not familiar with. They claim the campaign will not add to the workload of already over-stretched frontline nurses under pressure due to current staffing shortages.

“We’re very concerned about funding in the NHS and about the number of nursing posts that were going in order to save money – although that is changing at last,” said Ms Davies. “However, we don’t think it is right to complain about something without trying to find solutions.

“What we’re hoping is this won’t be massively time-consuming,” she added. “It’s the sort of work people are already doing as part of their clinical role. There may be times when people have to get together to have a conversation, but that will be time invested well.”

Ms Davies said a number of RCN members who work in procurement would be supporting the project. “There are some nurses who are focusing on this and doing some fantastic work already so we want to harness the energy of those people as well,” she said.

The organisers are keen to get nurses and healthcare assistants involved in shaping the campaign and will be staging focus groups during the summer and early autumn.

Nurses interested in getting involved can contact the RCN or email Rosalyn Sands at Rosalyn.Sands@supplychain.nhs.uk

we already do this within our trust and have done for a number of years, savings have always been made first on non pay to protect the pay. It seems to be down to nurses to count the pennies yet again!

No point in individuals undertaking this. You need to know who is responsible for this happening in your Trust. As it is probably already an exercise that is taking place and there will no doubt will clinical staff already involved.Many Trusts already employ clinical nurses to undertake these exercises and will already have logged substantial savings against their Trusts non-pay CIP.Asking individual nurses to sign-up could undo much of the hard work undertaken by Clinical Procurement nurses. Theres more to it than chosing the cheapest product on Supply Chain.

what about central purchasing for the NHS as an organisation? With modern logistics, individual hospitals can order standard items at a fixed price from companies with a supply contract, and deliveries can be made from the nearest depot. This would require some organisation in ensuring good stock control.

Savings on syringes and gloves? How does that work exactly? If I wear a pair of gloves it is to protect me or my patient, why would I use them otherwise. Syringes? do any nurses use them unnecessarily ? How? I am sorry but although I am all for saving money I do not understand the mention of those two items. However I am constantly amazed at the amount of disposables we do use. Everything that once was pre sterilised in a central area is now 'disposable' after use. Nothing is washed and reused, just thrown away. I shudder at the waste in every department. Apart from that I think most corners that can be safely cut have already been cut in most hospitals to save money. To say ' this is about all of us taking a little bit of responsibility.' Well I am glad that is clear, no pressure at all, just blame the nurses who use one extra wipe to make someone comfortable, one extra sheet when it is damp, perhaps stop putting the patient first and the finances to the front. We all suspect the poor old NHS will not survive in the coming years, but if it doesn't it will not be the fault of the dedicated nurses who have toiled to keep standards up with ever diminishing money.

Anonymous 3:17pm It isnt about not using products, it is about standardising so all the wards and departments are using the same kind of syringe or gloves. In our region we saved £254,000 just by changing all our syringes to one brand. Most Trusts have been doing this for the last 8 years but procurement teams need clinical support to help chose suitable products. Working together really can save thousands which means you can buy more equipment and support more nurses.

What concerns me is that the reason cited for trying to save this money is to, so say pay for nurses/ ? more nurses. I am not convinced this actually happens and it would just ultimately mean an even smaller budget for the Trusts involved. Cynical me, surely not!!!!!

This used to happened years ago with centralised stores, before individualised ward/dept budgets. I am now retired, but suggested years ago about wards/depts. getting together to place orders which may offer a discount, eg. for beds and large items. I also suggested that there could be savings, be it small, if electrical equipment, in offices that were unoccupied over weekends/ bank holidays, were switched off. It tends to happen for PCs, but not photocopiers, shredders, faxes, etc. It would also reduce the fire risk. I don't think either idea was taken up. So if this is to work, then management have to listen and take notice!! Also, there needs to be a direct link between your ideas and the person dealing with them, who is able to make a decision, other than having to go through every rung on the ladder from the bottom to the top, such a time and financial waste in itself. I would also like to see that the savings ARE actually passed on to nursing posts.

There is a lot of dead wood in the nhs, two and sometimes three people doing a job that can often be done by one. I'm not just talking non-clinical, but a rethink on ward or department managers above band 6 in some areas would save a lot of money, which in turn could encourage an irresponsible government to give grossly underpaid staff nurses a rise, before they all clear off abroad.

I am concerned that the article considers incontinence products as basics without thought to the people who have to wear them and whose dignity is affected if they do not meet their needs. Whilst some patients will only need incontinence products as a temporary measure, others depend on them to cope with longterm bladder and or bowel dysfunction. There is great variation between brands and different ranges of the same brand. People leak urine in different ways, some sudden large gushes, others small amounts frequently. Bowel leakage can vary equally. The wrong pad leads to unnecessary leakage, moisture related skin problems in people often at high risk of pressure ulcers. It is vital that wards stock a range of products so that patients have pads that meet their leakage needs, not by a stated maximum absorbency tested in lab. Many pads limit the ability for a person to use a toilet when able. Other urological devices including urinary sheaths, urine drainage bags and catheters are not generic products. Patients need products that promote independence and not reliance on others. Lack of choice on the ward, leads to patients being sent home with devices that they struggle to cope with and possibly need readmission when they cannot operate the drainage tap, or can not leave home as they have a bag on a stand.The Care Quality Commission states thatservice users are offered support in order to maintain their autonomy and independence in accordance with their needs and stated preferencesBeware of false economies, what may seem to have a theoretical saving may end up costing the NHS more.

If we go back 50 years, Matron would have been responsible for the stores function in the hospital and working closely with the supplies team would ensure that the products used delivered the quality, safety and value the hospital needed. Since then we have seen many different ways of trying to get to a NHS price for basic clinical consumables where clinicians could be confident the product will do what it says on the tin. Some of this has been addressed through national contracts (although too much choice) and so it falls to individual hospitals to make a decision on the 'gloves', 'syringe' etc it uses. Good Trusts have clinical product review groups or engage closely with nursing, medical and AHP staff to support decision making. Their are a number of Trusts who have employed nurses or AHP's in procurement and supplies team to help bridge this perceived gap and the evidence shows that the Trust gets better value for the products it uses.All of us have a responsibility to consider the cost of care but we all know from experience that the unit price is just one indicator of how this will benefit the patient. Working as a team will make sure we take into account all of the factors that lead to the decision to use a particular product/brand.Recognising the contibution nurses make in this area is great but could be dangerous to assume we are not already doing this today.I would be more in favor of the RCN focusing on best practice rather than a tool kit from just one of many suppliers to the NHS.As for whether this will deliver more nurses I am not sure it will but could help stop losing any more posts as deficits increase